Talk Cancer

Question:

I saw my oncologist yesterday and we reviewed the results of the PET scan. Essentially it reinforced his assessment that the cancer has recurred at the anastamosis and that there’s cancer in two par-aortal lymph nodes. There are no signs of metastasis to other organs. Jeanne, you’d asked me if I thought the test was worthwhile. I guess I have mixed emotions. It was an expensive (for me) test: $2500.00, and it didn’t offer any information that the radiologists had not interpreted from the CT scan. Note that I write "interpreted". It wasn’t cut and dried, based on the CT scan, that the cancer had come back. The oncologist had said that he’d based his original assessment on both the CT scan and blood work (rising tumour markers). He’d said that he felt 80% sure saying there was recurrence based on the CT scan alone. There’d been no clear proof (ie, biopsy) that the cancer had locally recurred, and the oncologist had said there was the possibility that the thickening tissue the CT scan revealed at the tumour bed might be scarring from the original surgery and the radiation I’d received. He felt 80% sure that it was cancer.  It was one of my fears that I would have the rest of my rectum removed, only to find that the thickening tissue had, in fact, been scar tissue. While this risk was probably small, it was an important issue for me. I don’t want major surgery and a colostomy unncessarily. The CT scan also provided some emotional relief in knowing that there is no measurable metastatis beyond what the oncologist had originally thought. So, for the most part, I feel that I got the confirmation I needed to know that we will make the best informed treatment decisions we can. Had my second round of chemo today. The irinotecan is kicking my ass a bit- it’s the fatigue, mostly. It wipes me out like 5FU and Leucovorin never did. I’m having very good results keeping the nausea and diarreah managed, though, and am happy about that. On a rambling, side note. I listened and watched as one of the nurses at the Vancouver clinic educated a first time chemo patient about her treatment, expected side effects, types of support provided by the clinic, etc.  Her intelligence, kindness, respect and compassion for her patient impressed me to no end. As do most of the oncologists I’ve been seeing. (my regular med. oncologist is on maternity leave, and I’ve seen 4 different oncologists since February, which isn’t ideal). But except for one or two issues which had me irritated (I do not want to be greeted by an oncologist with the phrase, "what’s up?"), my questions and desire to be as assertive and educated patient as I can be have been met with respect and a willingness to listen to me and hear about my concerns, hopes and fears. Steph and co.- I think you rock . Michele

Response:

Steph and co.- I think you rock . Michele

The street runs both ways Michele. I think many patients rock!

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